The Wall Street Journal article noted “Health insurers in several states are adding to the choices of doctors and hospitals in their health-law plans amid concerns among some consumers and state officials about access to care.”
“The insurers that are expanding their networks said they aren’t responding to complaints. Instead, they said, the tweaks reflect more willingness by some health-care providers to join the new networks, which often pay them less than traditional employer plans, as well as adjustments to serve the specific populations who enrolled.”
“But insurers also note that limiting the array of doctors and hospitals where services are covered can be a key tactic in keeping down costs. As a result, according to industry officials, narrow networks may expand in certain cases, but they will continue to be common among health-law plans.”
“A new analysis by McKinsey & Co. found that 48% of the networks in exchange plans nationwide have limited networks, which means plans with 70% or fewer of local hospitals participating as well as the tiered plans that have higher co-pays to use certain hospitals. But among the least-expensive plans, 69% had the more-limited networks, according to the McKinsey report. In the most popular silver tier of coverage, the plans with smaller networks had premiums that were a median 17% cheaper than similar plans offering a broad hospital selection.” The relatively limited choice of doctors and hospitals in many health-law plans drew criticism from consumers and scrutiny from some regulators as the first year of plans went into effect.
Click here to read the full Wall Street Journal article ”Some Companies Are Expanding Their Doctor and Hospital Networks” by Anna Wilde Mathews.
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Doctor, Did You Wash Your Hands? ™ provides information to consumers on understanding, managing and navigating health care options.
Jonathan M. Metsch, Dr.P.H., is Clinical Professor, Preventive Medicine, Icahn School of Medicine at Mount Sinai; and Adjunct Professor, Baruch College ( C.U.N.Y.), Rutgers School of Public Health, and Rutgers School of Public Affairs and Administration.
This blog shares general information about understanding and navigating the health care system. For specific medical advice about your own problems, issues and options talk to your personal physician.